RENTAL APPLICATION, "DOS RIOS" RIVERFRONT HOME, DUNNELLON, FL

Name ________________________________ Direct Phone ____________________

Home Tel #_________________________ Work Phone ___________________

Driver's license number, State:_____ #: ___________________________________________________

Date of Birth___________________

Present Address _____________________________________________________________________

How long at this address? ______________ Rent ? _________Own? _________

Owner/Landlord, if any: __________________________ Phone ___________________________________

Previous Address _____________________________________________________

How long at this address? ______________ Rent $ __________________

Name and relationship of every person to occupy premises, even if only temporarily (include names and ages of minors): _____________________________________________________

_____________________________________________________

Any pets? ______ Describe ________________________________

Occupation ________________________

Employer ___________________________________________

Phone _______________________________

Duration of Employment _______ Supervisor ________________________________ Phone _________________________

List sources of income (other than employment listed above ___________________________________________

_____________________________________________________

HAVE YOU...

ever filed bankruptcy? ____ ever been evicted? ____

ever been convicted of a felony? ___ ever been foreclosed on? ____.

Please explain:_______________________________________________

Vehicle Make __________ Model ____________ Year _________ License ___________

Vehicle Make __________ Model ____________ Year _________ License ___________

Personal Reference __________________________________

Address ____________________________________________________

Phone ___________________________, Relationship: _____________________

Contact in Emergency ___________________________________

Address _______________________________________________

Phone _________________________, Relationship:____________________

I declare that the information provided above is accurate and correct. I authorize verification of my references and employment as they relate to my tenancy and to future rent collection.

 _______________________________________________

Application Date_____________________________

your email_____________________________________________________

Desired Week(s)dates: (our week goes Sunday 4pm through Sunday 11am):__________________________________________________

Would You like to get the usage of 2 kayaks for the length of your stay, - 24/7 - , for only $125.00?: __________________________________________________

FAX FORM TO: 239-430-6034 OR SCAN IT AND THEN EMAIL IT TO: salomon@7florida.com, please attach copy of your driver's lic.

Once application is reviewed, we will formulate an agreement which will be sent to you for signatures and with instructions for payment.

Check in instructions and other trip details will be sent to you prior to your rental period via eamil. Thanks!